Tissue ablation is predominantly cancer therapy

Tissue ablation is defined as the “removal of a body part or the destruction of its function, as by surgery, disease, or a noxious substance.” Put more simply, ablation is considered to be a therapeutic destruction and sealing of tissue.

The technologies representing the majority of physical (rather than chemical) ablation are comprised of the following:

  • Electrical
  • Radiation
  • Light
  • Radiofrequency
  • Ultrasound
  • Cryotherapy
  • Thermal (other than cryotherapy)
  • Microwave
  • Hydromechanical

Source: Report #A145, "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities."

The largest share of the market for energy-based ablation devices is used in cancer therapy, primarily using the radiation therapy modality. Following that is general surgery with its use of electrocautery and electrosurgical devices, RF ablation, cryotherapy, etc. Cardiovascular is thought to be third, even though cardiovascular is making the most noise in the medical press with RF and cryoablation of atrial fibrillation, this segment is thought to be third in share order. The remaining applications are relatively small and fall in line behind the three leading sectors.

Growth in the Asia/Pacific Market for Ablation Technologies

 

The Asia-Pacific market for ablation technologies looks quite different from the Americas and European Union. Here, at present, the largest market is Japan, which accounts for the majority of the market, although by population and current growth rates, the People’s Republic of China has the greatest potential. Its greater than 1.3 billion population and, more importantly, the healthcare infrastructure that the government is putting into place ensure that China will continue to comprise an ever greater share of this market.

Asia-pacific-ablation

Data in the exhibit is drawn from MedMarket Diligence report #A145, "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities."

 

 

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Shifting caseload and markets in tissue ablation

Technologies to therapeutically ablate tissue (via destruction and/or removal of abnormal tissue or creation of a therapeutic lesion as in blocking errant electrical pathways in arrhythmia) represent a remarkably diverse set of tools despite their fundamentally common capability of tissue ablation.

Spanning electrical, radiation, light/laser, radiofrequency, ultrasound, cryotherapy, thermal therapy, microwave and hydromechanical and embodied in a wide range of medical devices and equipment, all ablation types simply destroy tissue.  The differences lie in respect to the specificity of each modality in targeting disease tissue and in respect to their capacity to be integrated in different types of instruments that may match the demands of specific clinical practices.

The recent history of ablation technology market developments reveals that, despite the specialization of modalities to specific tissues, or the efforts by manufacturers to carve out clinician or disease-state niches for specific modalities, growth in different ablation procedure types and clinical practice patterns has changed steadily but not always predictably.  Recent clinical results, new ablation device innovations and other developments have had the propensity to drive shifts in patient caseload between alternative ablation types.  Given the development and manufacturing costs, have largely and unsurprisingly maintained focus in typically one modality type, seeking to provide innovations in devices and equipment that accentuate benefits for there specific modality in specific clinical applications.

Below is illustrated the worldwide market for ablation technologies in 2009 and forecast 2019.

Source: "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities." Report #A145.

Evolution of ablation technologies and migration of caseload

Technologies to therapeutically ablate tissue (via destruction and/or removal of abnormal tissue or creation of a therapeutic lesion as in blocking errant electrical pathways in arrhythmia) represent a remarkably diverse set of tools despite their fundamentally common capability of tissue ablation.

Spanning electrical, radiation, light/laser, radiofrequency, ultrasound, cryotherapy, thermal therapy, microwave and hydromechanical and embodied in a wide range of medical devices and equipment, all ablation types simply destroy tissue.  The differences lie in respect to the specificity of each modality in targeting disease tissue and in respect to their capacity to be integrated in different types of instruments that may match the demands of specific clinical practices.

The recent history of ablation technology market developments reveals that, despite the specialization of modalities to specific tissues, or the efforts by manufacturers to carve out clinician or disease-state niches for specific modalities, growth in different ablation procedure types and clinical practice patterns has changed steadily but not always predictably.  Recent clinical results, new ablation device innovations and other developments have had the propensity to drive shifts in patient caseload between alternative ablation types.  Given the development and manufacturing costs, have largely and unsurprisingly maintained focus in typically one modality type, seeking to provide innovations in devices and equipment that accentuate benefits for there specific modality in specific clinical applications.

Below is illustrated the worldwide market for ablation technologies in 2009 and forecast 2019.

Source: "Ablation Technologies Worldwide Market, 2009-2019: Products, Technologies, Markets, Companies and Opportunities." Report #A145.

RF Ablation Proving Itself in Barrett’s Esophagus

From PRNewswire and Bio-Medicine.org… link.

Untreated epithelium in Barrett's esophagus

Results presented at this week’s Digestive Disease Week meeting in Chicago illustrated the effectiveness of BÂRRX Medical, Inc.’s HALO ablation system in the treatment of the pre-cancerous condition known as Barrett’s esophagus. The HALO ablation system uses radiofrequency (RF) energy to remove the epithelium in the esophagus of patients with Barrett’s esophagus (see image at right). In addition to these cell’s being pre-cancerous, Barrett’s esophagus is associated with chronic gastroesophageal reflux disease (GERD).

Results from a number of clinical trials were presented during the Digestive Disease Week (DDW) in Chicago this week, revealing new outcomes data related to endoscopic radiofrequency ablation using the HALO ablation system for eradicating a pre-cancerous esophageal condition known as Barrett’s esophagus. Among them, reports included durability outcomes from a randomized sham-controlled trial, safety and efficacy outcomes from a large U.S. registry of 429 patients, a randomized trial comparing ablation to endoscopic resection, and the largest European series to date in patients with high-grade dysplasia and early cancer.

As the DDW meeting commenced, the New England Journal of Medicine published a landmark paper entitled, "Radiofrequency Ablation for Barrett’s Esophagus Containing Dysplasia."  This is a U.S. randomized sham-controlled trial demonstrating high rates of complete eradication of barrett’s and dysplasia in the ablation group as compared to control, as well as a significant reduction in cancer progression.  At DDW, researchers presented new data from this now published trial showing that the ablation effect achieved at 1 year follow-up was highly durable at the 2-year follow-up.  

RF ablation is among a wide-range of energy-based technologies — cryo, microwave, laser, ultrasound, etc. — that are progressively penetrating virtually all clinical specialties where there is a need to selectively, with good clinical control and outcomes, therapeutically remove or ablate tissues.

(See the MedMarket Diligence report #a125, "Worldwide Ablation Technologies, 2008-2017", described at link.)

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Energy-based therapeutics markets by clinical application

Energy-based therapeutics include technologies to effect the destruction or treatment of tissues to remove pathology or otherwise modify tissue (e.g., for creating lesions that block the aberrant signals in arrhythmia).  These technologies include radiofrequency, microwave, laser/light, microwave, cryo, hydromechanical, ultrasound and thermal.

Some sectors of the energy-based market are growing steadily, others more rapidly. RF ablation is seeing lively growth, as are cryotherapy and microwave therapy. Overall, the market is estimated to be increasing at more than 11% per annum, which is significantly higher than growth of the medical device market overall. The buoyancy in the energy-based sector is due partly to increased uptake of these technologies and partly due to introduction of technology refinements, which in turn lead to increased usage. There is also the demographic factor; many of the conditions for which ablation products are used are commoner among older than younger patients, and lengthening life expectancy makes its own contribution to market growth.

Certain clinical sectors demonstrate a more significant share of the ablation market due to the prevalence of diseases and disorders that are amenable to these treatments.  See the current segmentation of the ablation market by clinical application.

energy-by-applicatoins

Source:  MedMarket Diligence report #A125, "Worldwide Ablation Technologies Market."

Cardiovascular applications represent the most significant application, due to the existing caseload and the adoption of ablation technologies, especially in arrhythmia management.  Secondarily, but perhaps with an even greater upside potential, is cancer therapeutics.  

Below see the current distribution of ablation therapy markets across different solid tumor types.

solid-cancers-ablation

Source:  MedMarket Diligence report #A125, "Worldwide Ablation Technologies Market."

 

Ablation technologies market growing rapidly worldwide, particularly in select modalities

The worldwide high energy therapies market represents a $25 billion opportunity in 2008. The category consists of therapeutic devices and equipment that deliver the controlled application of one or more modalities of energy to tissue.

The market will grow at an aggressive rate through 2017 for all modalities, but with some modalities exceeding compound annual growth rate of 20%.  As a result of this, the adoption and growth of energy therapies will exceed the growth of the overall medical device market and the mix of energy therapies will increase.

Below is illustrated the aggregate growth of the ablation therapies market worldwide, by segment, and the relative growth of each of the segments in the market.

ablation-market-total

Note: Total market in  $millions

Source:  MedMarket Diligence Report #A125, "Ablation Technologies Worldwide Market, 2007-2017."